Nonalcoholic fatty liver disease (NAFLD) has become an increasing epidemic. It is the most common cause of elevated liver enzymes, and it is associated with diabetes and obesity with advanced liver disease.

There are few guidelines for diagnostic and follow-up methods and limited proven treatment options. Previous research of pharmacological agents to treat NAFLD were performed with poor results.

According to a study just published this week in Nutrients, researchers investigated the effects of long-term fish oil supplementation in patients with nonalcoholic fatty liver disease (NAFLD).

 This study was a randomized, double-blinded, placebo-controlled trial conducted between January 2018 and February 2020 that included 24 patients who were >19 years of age with ultrasound-proven fatty liver disease. The patients were randomized to receive either fish oil supplementation (1,509 mg of DHA; 306 mg of EPA) or a placebo (2,250 mg of oleic acid) for a 6-month period. Assessments for analysis performed at baseline and after intervention included circulating microRNA-122 expression, liver fibrosis (diagnosed with FibroScan®), red blood cell fatty acid profile, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), fasting glucose, hemoglobin A1c, and lipid profile.

As a result, there was a significant increase in the omega-3 index in the fish oil supplementation group. In addition, there was a significant decrease in ALP levels and liver fibrosis. ALP is commonly used as a marker of liver and bone pathology, and it is an independent risk factor for NAFLD. In addition, increased levels of ALP have been shown in NAFLD patients who have stage 1 and stage 2 liver fibrosis. There was no difference in omega-3 index levels in the placebo group.This study demonstrated that fish oil supplementation was incorporated in the red blood cells after 6 months, and fish oil supplementation was effective in reducing liver fibrosis and ALP levels.

These individuals are in a state of chronic disease with increased demands for what could be obtained from the diet alone. Therefore, dietary supplements should be considered to potentially help prevent the progression and maintain liver function. Other nutrients to consider include tocotrienols, phosphatidylcholine, fiber or resistant starch, N-acetylcysteine, and probiotics.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

 Source: Cansanḉᾶo K, Citelli M, Carvalho Leite N, et al. Impact of long-term supplementation with fish oil in individuals with non-alcoholic fatty liver disease: a double blind randomized placebo controlled clinical trial. Nutrients. 2020;12(11):3372. doi.org/10.3390/nu12113372.